Fusion Proteins, bcr-abl ; Humans ; Leukemia, Myelogenous, Chronic, BCR-ABL Positive ; Male ; Middle Aged

Objective To explore the effect of the straight line and the auxiliary incision of lip skin on repairing unilateral incomplete cleft lip.Methods 120 cases of unilateral incomplete cleft lip repaired with the straight line method and reconstruction of the orbicularis oris muscle with the auxiliary incision of lip skin.Results 2 cases of cleft relapse by tumble.The wound of 115 children were healed one stage.3 children were healed two stage.All children didn't present vermilion deficiency.The upper lip presented natural labial groove between affected and unaffected side.Both sides of nostrils were symmetry and scars were not ovbious.Conclusion This new method was simple and effective in repairing unilateral incomplete cleft lip.

OBJECTIVETo explore clinical efficacy of double Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I in treating acromioclavicular dislocation with Rockwood type III - V .

METHODSFrom January 2010 to September 2013, 56 patients with Rockwood type III - V acromioclavicular dislocation were treated by operation, including 20 males and 36 femlaes, aged from 32 to 52 years old with an average of 38.5 years old. Twenty-five patients were on the left side and 31 cases on the right side. The time from injury to operation was from 3 to 14 days, averaged 7 days. All patients were diagnosed as acromioclavicular dislocation with Rockwood type III - V, and double Endobutto were used to reconstituting coracoclavicular ligament, line metal anchors were applied for repairing acromioclavicular ligament. Postoperative complications were observed, Karlsson and Constant-Murley evaluation standard were used to evaluate clinical effects.

RESULTSAll patients were followed up from 8 to 24 months with average of 11 months. According to Karlsson evaluation standard at 6 months after operation,42 cases were grade A, 13 were grade B and 1 was grade C. Constant-Murley score were improved from (42.80±5.43) before operation to (91.75±4.27) at 6 months after operation. All items at 6 months after operation were better than that of preoperative items. Forty-eight patients got excellent results, 7 were moderate and only 1 with bad result. No shoulder joint adhesion, screw loosening or breakage were occurred during following up.

CONCLUSIONDouble Endobutto reconstituting coracoclavicular ligament combined with repairing acromioclavicular ligament in stage I for the treatment of acromioclavicular dislocation with Rockwood type III - V could obtain early staisfied clinical effects, and benefit for early recovery of shoulder joint function.

Acromioclavicular Joint ; injuries ; surgery ; Adult ; Bone Plates ; Bone Screws ; Female ; Humans ; Ligaments, Articular ; injuries ; surgery ; Male ; Middle Aged ; Reconstructive Surgical Procedures ; Shoulder Dislocation ; surgery ; Treatment Outcome

In the present paper, the contribution of the largest principal component and the number of principal component needed for accumulative contribution 95% are selected as indices of electroencephalogram (EEG) in mental fatigue state in order to investigate the relationship between these parameters and mental fatigue. The experimental results showed that the contribution of the largest principal component of EEG signals increased in the prefrontal, frontal and central areas, while the number of principal component needed for accumulative contribution decreased by 95% with the increasing mental fatigue level. The parameters of singular system of EEG signals can be regarded as useful features for the estimation of mental fatigue and have larger application value in the study of mental fatigue.
Electroencephalography ; Humans ; Mental Fatigue ; Principal Component Analysis

ObjectiveTo investigate the distribution and expression of y-secretase subunit (APH-1)in the central nervous system (CNS) of APP/PS1 double transgenic Alzheimer's disease (AD) adult mouse model,and to detect the expression difference of APH-1 in developmental brain between AD model mouse and wild-type littermates in order to further clarify the relationship between APH-1 and AD. MethodsOffspring bred by APP/PS1 double transgenic AD mice were genotyped.Immunohistochemical staining was used to detect APH-1 distribution and expression in the CNS of adult APP/PS1 double transgenic AD mouse model,in the brain of AD model mouse and its wild-type littermates on postnatal day 1,7,21 and 120.Results APH-1 was widely expressed in almost all regions of the CNS,especially in the cerebral cortex,hippocampus,olfactory bulb,hypothalamus,ventral striatum,caudate putamen,raphe magnus nucleus,cerebellum,brainstem and spinal cord of the adult APP/PS1 double transgenic mice.APH-1 expression was higher in the cortex of both AD and wild type mouse on postnatal day 1 than on postnatal day 7 and 21 with increased level of APH-1 protein in adult mouse brain.APH-1 expression in the brain of AD mice was higher than in its wild type littermates at any stage(P＜0.05).Conclusions Distribution of APH-1 is ubiquitous and region-dependent in the CNS.The different distribution and expression between APP/PS1 double transgenic mouse model and its wild type littermate indicate that APH-1 may be related to AD.

Objective:To explore the value of improved sequential organ failure assessment (ISOFA) in predicting the prognosis of Klebsiella pneumoniae sepsis. Methods:The clinical data of 379 patients with Klebsiella pneumoniae sepsis admitted to the First Hospital of Jilin University from January 1, 2018 to June 30, 2019 were retrospectively analyzed.They were divided into survival group and death group according to the 28-day prognosis, and the age, gender, C-reactive protein, procalcitonin, grade of bacterial resistance, and the occurrence of septic shock of the two groups were compared.Statistical analysis was conducted by using independent sample t test, Mann-Whitney U test and chi-square test. Risk factors for the prognosis of the disease was analyzed by logistic regression analysis.The correlation between ISOFA and other scoring system including Charlson′s weighted index of comorbidities (WIC), national early warning system (NEWS), acute physiology and chronic health evaluation Ⅱ (APACHEⅡ), simplified acute physiology scoreⅡ (SAPSⅡ), mortality in emergency department sepsis score (MEDS), sequential organ failure assessment (SOFA), acute gastrointestinal injury (AGI) was determined by Spearman correlation coefficient.The area under the receiver operating characteristic curve (AUROC) was used to compare the evaluation value of each scoring system for the prognosis of Klebsiella pneumoniae sepsis. The clinical significance of ISOFA risk stratification was evaluated by Kaplan-Meier survival curve. Results:Among the 379 patients with Klebsiella pneumoniae sepsis, 278 were in the survival group and 101 were in the death group.The differences of age, gender, the occurrence of septic shock, grade of bacterial resistance, C-reactive protein, procalcitonin, WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS, SOFA, AGI and ISOFA score between the two groups were all statistically significant ( t=-3.218; χ2=6.781, 24.374 and 27.208, respectively; Z=-3.689, -5.022, -4.396, -4.697, -7.438, -6.348, -6.358, -8.676, -6.680 and -11.658, respectively; all P<0.01). The calculation method of ISOFA was obtained by single factor analysis: ISOFA=SOFA+ 1.5×AGI.Multivariate logistic regression suggested that ISOFA, gender, SOFA, procalcitonin, C-reactive protein, and bacterial resistance were independent risk factors for the prognosis of the disease. The Spearman correlation coefficients of ISOFA and WIC, NEWS, APACHEⅡ, SAPSⅡ, MEDS and SOFA were 0.327, 0.371, 0.614, 0.564, 0.578 and 0.847, respectively. The AUROC and its 95% confidence interval for WIC, NEWS, MEDS, SAPSⅡ, APACHEⅡ, SOFA alone, SOFA plus AGI, and ISOFA to predict the prognosis of Klebsiella pneumoniae sepsis were 0.646 (0.584-0.708), 0.657 (0.597-0.716), 0.712 (0.654-0.771), 0.713 (0.653-0.773), 0.749 (0.693-0.806), 0.788 (0.737-0.838), 0.872 (0.826-0.917) and 0.891 (0.845-0.937), respectively.The results showed that ISOFA had the best predictive effect.The Kaplan-Meier survival curve suggested that there were statistical differences in survival rate among ISOFA low-risk level, medium-risk level, and high-risk level (all P<0.01). Conclusion:ISOFA has important clinical significance in predicting the prognosis of Klebsiella pneumoniae sepsis.

Objective To investigate the effect and mechanism of ischemic postconditioning (IPC) on myocardial perfusion levels of acute ST-segment elevation myocardial infarction (STEMI) patients having underwent primary percutaneous coronary intervention (PCI), and the safety of IPC. Methods One hundred and sixty patients with STEMI were enrolled, and they accepted the primary PCI therapy within the onset of 12 h. The patients were divided into 2 groups according the treatment method:control group (routine PCI group, 82 cases) and IPC group (78 cases). The ST-segment resolution, TIMI myocardial perfusion grade (TMPG), before and after PCI levels of nitrogen monoxidum (NO), endothelin (ET)-1, tissue-type plasminogen activator (t-PA), plasminogen activator inhibitor (PAI)-1, rate of intraoperative complication were observed. The patients were followed up for 6 months, the rate of major adverse cardiac event (MACE) was recorded. Results The rates of ST-segment resolution and TMPG well in IPC group were significantly higher than those in control group:84.62%(66/78) vs. 67.07%(55/82) and 80.77%(63/78) vs. 64.63%(53/82), and the rate of ischemia-reperfusion injury in IPC group was significantly lower than that in control group: 7.69%(6/78) vs. 24.39%(20/82), and there were statistical differences ( P<0.05 or<0.01). The endothelial function and fibrinolysis activity indexes (NO, ET-1, t-PA and PAI-1 levels ) 7 d after PCI in IPC group were significantly better than those in control group: (52.37 ± 3.84) μmol/L vs. (50.95 ±3.85) μmol/L, (75.47 ±3.47) ng/L vs. (76.61 ±3.72) ng/L, (12.96 ±1.25) μg/L vs. (12.52 ±1.23) μg/L, (21.78 ±4.01)μg/L vs. (24.95±7.56)μg/L, and there were statistical differences (P<0.05 or<0.01). There was no statistical difference in the rate of intraoperative complication between 2 groups ( P>0.05). The rate of MACE in IPC group was significantly lower than that in control group:3.85% (3/78) vs. 14.63% (12/82), and there was statistical difference (P<0.05). Conclusions Applying IPC in patients with STEMI having underwent primary PCI is safe and can improve myocardial perfusion levels. The improvement of vessel endothelial function and fibrinolysis activity attained from IPC may be the major mechanism.

BACKGROUND:Single fracture or colapse of the posterolateral tibial plateau fractures is relatively rare in the clinical work. Rational choice of surgical approach and internal fixation for posterolateral plateau fracture is significant to restore the lower limb force line, maintain the joint stability and obtain good biocompatibility.
OBJECTIVE:To compare the stability and biocompatibility of Carlson posterolateral and posterior midline approaches for the treatment of posterolateral tibial plateau fractures with “T” shaped locking plate.
METHODS:From July 2011 to July 2014, 43 patients with posterolateral tibial plateau fractures, who were treated in the Affiliated Hospital of Jining Medical University, were retrospectively analyzed. Al patients were assigned to two groups according to approaches. In the Carlson posterolateral approach group, 22 cases received “T”-shaped plate insertion by Carlson posterolateral approach. In the posterior midline approach group, 21 cases received “T”-shaped plate insertion by posterior midline approach. After repair, perioperative data, fixation effects and knee function score were compared and analyzed between both groups.
RESULTS AND CONCLUSION:(1) 43 cases (43 knees) of posterolateral tibial plateau fractures were folowed up strictly. (2) No significant difference in operation time, fracture healing time, total load time, Hospital for Special Surgery score at 12 months postoperatively, tibial plateau angle and posterior slope angle immediately and 12 months postoperatively was detected between both groups (P > 0.05). (3) Significant differences in fracture exposure, blood loss, and excelent and good rate of Rasmussen at 12 months postoperatively were identified in both groups. Moreover, above indexes were better in the Carlson posterolateral approach group than in the posterior midline approach group (P< 0.05). (4) These findings confirmed that for a single fracture or colapse of the posterolateral tibial plateau fractures, two kinds of surgical approaches can achieve ful and direct exposure. Carlson posterolateral approach has good repair effect, fixation effect and biocompatibility.

Objective To observe the efficacy and safety of the etomidate target controlled in-fusion (TCI)in the total thoracoscopic mitral valve replacement surgery.Methods One hundred and ten patients,aged 29-55 years,48 males and 62 females with ASA grade Ⅱ or Ⅲ rheumatic mitral valve disease planned to be corrected with total thoracoscopic mitral valve replacement surgery were randomly divided into group E and group P,55 cases in each group.In group E,etomidate-sufentanil target controlled infusion was used for induction (the initiate plasma concentration of etomidate was 0.2 ng/ml and increased 0.1 ng/ml per minute according to the bispectral index and the effect-site concentration of sufentanil was maintained at 1.0 ng/ml)and maintenance.In group P,using propo-fol-sufentanil target controlled infusion for induction (the initiate plasma concentration of propofol was 1.0 ng/ml and increased 0.3 ng/ml per minute according to the bispectral index and the effect-site concentration of sufentanil was maintained at 1.0 ng/ml)and maintenance.We documented the incidence of hypotension during the induction phase, recorded the basic clinical parameters of patients,the dosage of vasopressors during induction and sufentanil during anesthesia,time of eyelash reflex absence,operation time,CPB time,clamping time,APACHE Ⅱ score when enter CCU,pos-itive inotropic score 24 h postoperatively,wakening time,mechanical ventilation time,CCU stay,in-hospital stay,blood glucose and lactic acid preoperatively,2,6,24 h postoperatively,cortisol,aldo-sterone and adrenocorticotropin preoperatively and 24 h postoperatively and postoperative complications in both groups.Results The incidence of hypotension during induction in group E was much lower than that in group P (P<0.05).The dosage of norepinephrine during the induction in group E were much less than group P (P <0.05).The wakening time,mechanical ventilation time,CCU stay and in-hospital stay in group E were significantly shorter than group P (P <0.05).The blood glucose and lactic acid at postoperative 2,6,24 h were much higher than the preoperative value within each group (P <0.05).They reached the maxim at 6 h postoperatively and began to decline at 24 h postoperatively. Blood glucose and lactic acid at all the time points between two groups were similar.Cortisol at 24 h postoperatively was much higher than the preoperative value in group P (P <0.05).The dosage of cortisol and aldosterone 24 h postoperatively in group E were much less than that in group P (P <0.05).The incidence of postoperative lung infection in hospital in group E was remarkably lower than that in group P (P <0.05).Conclusion Etomidate target controlled infusion can maintain stable he-modynamics during the induction period, shorten postoperative recovery time and reduce postoperative lung infection obviously,which can be safely used in total thoracoscopic mitral valve re-placement surgery.